Shiga bacillus dysentery associated with marked leukocytosis and erythrocyte fragmentation

Abstract

Granulocytic leukemoid reactions (white blood cell counts greater than 50,000 with myelocytes and promyelocytes in the peripheral blood) were documented in 15 per cent of 273 patients with dysentery due to Shigella dysenteriae, type 1 (Shiga bacillus) in Bangladesh. Peak granulocytosis occurred during the second week of illness, when the children were commonly afebrile and diarrhea had ceased or was subsiding. More than half of the patients with leukemoid reactions subsequently developed a fall in hematocrit associated with striking erythrocyte fragmentation on blood smears. Thrombocytopenia occurred during the period of hemolysis in most. Transient oliguric renal failure developed in several patients. Most made a complete recovery. The pathogenesis of the syndrome and the reason for its high incidence were not determined.